Word count = 2703 |
Contents
Abstract 3 Introduction 4 Spinal cord injury 4 Current Management 5 The Literature 7 Cervical spine immobilization 7 Full spinal immobilization 9 Conclusion 11 Bibliography 12
Abstract
Background: A literature review form a variety of references, in particular journal articles, textbooks and information from appropriate academic websites. These resources have been analysed and a conclusion drawn from them in regards to spinal immobilisation in the pre-hospital setting. Method: This assignment uses an evidence based approach; the author explores spinal injuries and the current management of them in the pre-hospital setting across a number of countries. The author relates current practice with recent literature and draws a final conclusion from the findings.
Conclusion: Prehospital care for patients with acute traumatic spinal injuries requires great care to avoid secondary injury; recognition of potential injury is of great importance. Although injuries to the spinal cord occur in 2% of the patients that paramedics immobilize, pre-hospital management and treatment can play a significant role in the patient’s outcome. There is growing evidence that full body immobilization can be of more harm than good if not done correctly.
Introduction
Traumatic spinal cord injuries are severe, life threatening and life altering. Managing the risk of spinal cord injury in trauma patients is an understandable concern for medical professionals. Spinal immobilization is initiated on a regular basis in pre-hospital setting for patients at risk of a spinal cord injury. In the past immobilization has been thought to be a relatively harmless procedure. There is now, however, growing evidence that this approach can be harmful, pre-hospital spinal immobilization in trauma patients should
Bibliography: Abram, S., & Bulstrode, C. (2010). Routine spinal immobilization in trauma patients: What are the advantages and disadvantages. The Surgeon, 218-222. Alejandro, A., & Schiebel, N. (2006). Is routine spinal immobiilization an effective intervention for trauma patients? Emergency Medicine, 110-112. Bernhard, M., Gries, A., Kremer, P., & Bottiger, B. (2005). Spinal cord injury - Prehospital management. Resuscitation, 127-139. Clinical pratice guidelines - Trauma. (2011, September). Retrieved from Queensland Ambulance Service: http://www.ambulance.qld.gov.au/medical/pdf/09_cpg_trauma.pdf Dunn, T Emergency medical services pre-hospital treatment protocols. (2012, January 3). Retrieved from Commonwealth of Massachusetts : http://www.mass.gov/eohhs/docs/dph/emergency-services/treatment-protocols-1001.pdf Engsberg, J Horodyski, M., DiPaola, C. P., Conrad, B. P., & Rechtine, G. R. (2011). Cervical collars are insufficient for immobiliaing an unstable cervical spine injury. The Journal of Emergency Medicine, Vol 41, 513-519. Hostler, D., Colburn, D., & Seitz, R. (2009). A comparison of three cervical immobilization devices. Prehospital emergency care(13), 256-260. Krell, J. M., McCoy, M. S., Sporto, P. J., Fisher, G. L., Stoy, W. A., & Hostler, D. P. (2006). Comparison of the Ferno scoop stretcher with the long backboard for spinal imobilization. Prehospital Emergency Care, 46-51. Leonard, J. C., Mao, J., & Jaffe, D. M. (2012). Potential adverse effects of spinal immobilization in children. Prehospital Emergency Care, 513-518. Marieb, E. N., & Hoehn, K. (2010). Human Anatomy & Physiology (8th ed). Benjamin Cummings. Northwest region EMS protocols. (2012, January). Retrieved from Northwest Region Emergency Medical Services & Trauma Care Council: http://www.kitsapcountyems.org/admin/uploads/File/2012%20NWREMS%20Kitsap%20Protocols%20final%20May%202.pdf Peery, C Ramasamy, A., Midwinter, M., Mahoney, P., & Clasper, J. (2009). Learning the lessions from conflict: Pre-hospital cervical spine stabilisation following ballistic neck trauma. Injury, 1342-1345. Sanders, M. J. (2012). Mosby 's Paramedic Textbook (4th ed.). Elsevier. Saskatchewan Emergency Treatment Protocol Manual. (2012, October 17). Retrieved from Ministry of Health Guidelines : http://www.health.gov.sk.ca/ems-protocol-manual Stiell, I., Clement, C Tintinalli, J. E. (2011). Emergency Medicine A Comprehensive Study Guide, 7th ed. Mc Graw Hall. Vaillancourt, C., Stiell, I. G., Beaudoin, T., Maloney, J., Anton, A. R., Bradford, P., . . . Wells, G. (2009). Out-of-Hospital Validation of the Canadian C-Spine Rule. Annals of Emergency Medicine, 54. Wellington Free Ambulance Clinical Practice Guidelines – Comprehensive edition. (2012). Retrieved from Wellington Free Ambulance: http://www.wfa.org.nz/